World Bank Group President Jim Yong Kim's Q&A with media at Hospital do Subúrbio PPP Project site in Brazil

DR. KIM: [Inaudible progress] -- The services - Ministry of Health of the state have made available to the people of Bahia, that's the most impressive, to have free care, to be open to anyone who needs care, to be so focused is a tremendous accomplishment.

QUESTION: Do you see this project as an example for the other states in Brazil and why not other countries as well?

DR. KIM: Absolutely. You know, the speed with which they've gotten the hospital built the fantastic quality of the services, and I took a very careful look. I'm a physician, I took a very careful look, and I was very impressed with what they have.

You know, we've got to find a way to quickly improve health care services. We've got to find a way to get the incentives right both for health care systems and physicians, and this project is moving in a wonderful direction. We think that this public-private partnership could have tremendous benefits for the population. We have to find out how to get it right in every state and every setting, but we think that there is a strong role for these kinds of partnerships.

QUESTION: How can you explain this visit today?

DR. KIM: This is my first visit as President of the World Bank Group to Brazil and, as the Governor suggested, it was completely appropriate for me to come to Bahia first, because Bahia, as he said, is -the beginning and the center of Brazil.

QUESTION: Has the World Bank got the intention of taking part in any other project of this nature?

DR. KIM: Well, you know, we're very involved in Brazil. My predecessor, Bob Zoellick, when he met with President Dilma before, President Dilma Rousseff asked him specifically to focus on the northeast, and so that's why we're here.

We think it's a very high priority, but I have to say, Governor, I just congratulate you for the fantastic work you've been doing.

DR. KIM: You know, there are really some fundamental problems that everybody, every country in the world faces. One is economic growth, but the other is social exclusion, and what we see here in Brazil is a commitment to tackle both economic growth and social inclusion at the same time, which we think is very exciting and clearly an example for the world.

I'll be going down to Brasilia and we'll be signing an agreement where we are going to look at the experience of Brazil, both in poverty reduction and in fostering economic growth and trying to gather those lessons so that we can share them for the rest of the world. This hospital is one of those lessons that we'd like to share with the rest of the world.

QUESTION: So, we can compare this hospital with a hospital in First World place?

DR. KIM: Well, there are some differences, and I think that some of the differences are good differences.

You know, one of the things that we found in the developed countries is that we often spend too much money on health care.

And the thing about health care is it's not a situation where people can have as much as they want, and that's good. Once you give too much health care, that actually hurts people. So, what the situation in the United States is that they're looking for ways of decreasing their health spending, and that will actually be better for patients.

But Brazil, and this hospital in particular, is dealing with very poor patients. So, for me, the mix of extremely high technology, very skilled physicians treating very poor patients is not only a vision for the future, it's very inspiring.

QUESTION: What is the importance of being a PPP, a private-public partnership?

DR. KIM: Well, you know, often what you find is that the private sector will move much more quickly. So, the private sector has a bottom line. They have to figure out ways of both getting good outcomes and reducing costs.

The exciting thing here is that the private sector is being held to very high standards. In other words, the quality of the care, the outcomes for the patients, is very important. And that's where the state comes in and says, "We demand that you have very high-quality outcomes," and then the private sector then is, in a very entrepreneurial way, is figuring out how to get good outcomes while also reducing costs.

The good news is that there are many examples out there in the world where you can both lower your cost and improve the outcomes, and I'm very impressed with the way this hospital is approaching that situation.

QUESTION: What is your impression about the Sao Bartolomeu area you visited? …

DR. KIM: You know, the effort to take communities that were really at risk-- I mean, they were living in areas that were literally at risk just physically but also living in areas that were not sanitary. There was flooding, etc.

And the effort to even raise up the land, put in fill, and then build these apartments were, as well, very inspiring. I mean, I think the housing looked very, very good, people wanted to be in there, and the path toward economic growth, the path toward the future for Brazil is especially exciting for me. I've been working in some of the poorest countries in the world for most of my adult life, and to see a government saying that, "We want economic growth but we want to include everybody in that growth," this is, I think, an incredibly important message for the entire rest of the world.

DR. KIM: When we have seen problems in places like the Arab Spring, there was economic growth. The gross domestic product, the GDP, grew, but it didn't include young people, it didn't include women, it didn't include everybody in the society, and that built instability into their societies.

And so, the Brazilians, by saying, "We're going to be inclusive and we're going to grow," that's the right message for everybody.

QUESTION: [Unclear]

DR. KIM: Well, I think the experience in Brazil has already been a tremendous example.

You know, the program, Bolsa Familia, has been an example throughout the world, and I have seen people trying to replicate Bolsa Familia every--I was in Haiti and that's exactly what they were trying to do. And in fact, the Haitians had come to Brazil to learn about it.

The notion that you are going to connect education and health care with social protection, those three together, that's one of the most exciting ideas that I've ever heard of, and most countries don't do that.

So, the Bolsa Familia Program very self-consciously saying we're going to connect those areas. "We will give you economic support, but then you have some responsibilities: You have to keep your children in schools, you have to make sure they're fed, you have to make sure that they continue in school." This is a great idea and it's spreading all over the world already. And I think ideas like this PPP could also be ones that spread throughout the world.

QUESTION: [Inaudible]

DR. KIM: You know, most people have a fundamental misunderstanding and they think that health care is about technology. Health care, first and foremost, is about solidarity, and the Brazilians got the solidarity right. That's why this hospital is working effectively, because the insistence was that this is for poor people, and that you're going to have to deliver outcomes, results, for the poor people, and then the technology comes next. This is the most important thing. It's a lesson for everybody in the world.